Search PubMed⌕ Search

Biomedical subjects

M Jordan

Publications and source records attributed to M Jordan.

At least 127 records · Page 7Linked to original sources

Biological effects of shock waves: cavitation by shock waves in piglet liver.

Shock waves are known to generate cavitation in vitro. In vivo, extracorporeal shock waves may cause haemorrhages in tissues. Two types of changes were detected by conventional, real-time B-scan ultrasound when shock waves were administered to 5 piglet livers in vivo: transient changes consisting of bright signals in intrahepatic branches of the portal vein and tributaries of the hepatic vein, presumed to originate from gas bubbles, and stationary changes consisting of brightening of the area along the long axis of the high pressure field, presumed to indicate an increased number of gas-filled bubbles in this area. Transient changes appeared from the start of shock wave administration; bright signals were seen in liver vessels for several hundred microseconds before they were flushed away with the blood flow. Stationary changes appeared later, increased in intensity over several hundred shock waves and persisted for minutes after cessation of shock wave administration. Both types of signals were interpreted as direct evidence that lithotripter shock waves generated cavitation in vivo. Similar signals were received in the partly degassed water of the lithotripter tub. At autopsy of the piglets, focal intralobular haemorrhages and thrombi of portal veins were detected in the shock wave path. The occurrence of cavitation and tissue damage in the same gross area suggests that cavitation might be involved in the generation of tissue damage by shock waves.

Animals↗

Overview of FK506 in transplantation.

FK506 is a potent immunosuppressive agent which is undergoing clinical testing in liver, kidney, heart, and bone marrow transplantation. It has been shown to effectively prevent and reverse ongoing rejection in these models. From the outset, FK506 was used with low-dose steroids to treat 110 primary liver, 30 heart, and 66 kidney graft recipients. FK506 was also used in the setting of complications related to CsA or to ongoing chronic or acute rejection. One hundred seventy-three liver, 21 kidney, 10 heart, and 11 bone marrow recipients were converted to FK506 and low-dose steroids, from a combination of CsA, steroids, and/or Aza. A randomized, prospective trial comparing FK506 with CsA in primary liver transplantation has verified the lower incidence of rejection and greater ease in treating rejection episodes, with fewer adverse effects. In summary, FK506 has proven to be an effective baseline immunosuppressive agent, as well as a dose-adjustable agent for the treatment of rejection.

Anti-Bacterial Agents↗

The recognition of higher qualifications in the EC.

In 1988 the European Commission reached agreement on a directive on the recognition of professional qualifications obtained after three years training in institutions throughout the community. This directive comes into force next year. In this article Michael Jordan explains the effect this will have on those wishing to work in other countries within the EC, and describes how the directive will be administered.

Europe↗

Organization of Methanobacterium thermoautotrophicum bacteriophage psi M1 DNA.

psi M1 is a virulent bacteriophage of Methanobacterium thermoautotrophicum strain Marburg. Restriction enzyme analysis of the linear, 30.4 kb phage DNA led to a circular map of the 27.1 kb psi M1 genome. psi M1 is thus circularly permuted and exhibits terminal redundancy of approximately 3 kb. Packaging of psi M1 DNA from a concatemeric precursor initiates at the pac site which was identified at coordinate 4.6 kb on the circular genome map. It proceeds clockwise for at least five packaging rounds. Headful packaging was also shown for psi M2, a phage variant with a 0.7 kb deletion at coordinate 23.25 on the map.

Bacteriophages↗

Results of a multicenter outpatient burn study on the safety and efficacy of Dimac-SSD, a new delivery system for silver sulfadiazine.

Dimac with silver sulfadiazine (Dimac-SSD), a new silver sulfadiazine delivery system, was evaluated prospectively in a multicenter study for the treatment of outpatient burn injuries. The goal of this study was to evaluate the effect of Dimac-SSD on the microbiology of the burn wounds and to quantitate its clinical safety and efficacy. A total of 197 patients were evaluated. Eight (4%) of these patients did not complete the study. Six patients withdrew because of local discomfort caused by the Dimac-SSD and two patients were terminated because of technical problems. The mean +/- SD duration of treatment with Dimac-SSD was 12 +/- 8.5 days, during which time the mean number of dressing changes was 2.9 per patient. During treatment with Dimac-SSD, the burn wound bacterial flora remained stable and overgrowth with Pseudomonas species or Gram-negative bacilli did not occur. Only four (2%) patients developed clinical infections; thus the Dimac-SSD appeared to have good antimicrobial effectiveness. This dressing was not associated with any organ system or metabolic side-effects and patient discomfort during application and removal was minimal. Thus this new delivery system for silver sulfadiazine was associated with excellent wound healing, a low incidence of wound infections, reduced frequency for dressing changes, and excellent patient compliance.

Acrylates↗

Family history of anxiety disorders in control subjects with lactate-induced panic attacks.

The authors infused 45 control subjects with sodium lactate. Eight of 10 subjects with lactate-induced panic attacks and 26 of 35 without panic attacks were interviewed. An investigator, blind to the outcome of the infusion study, obtained family histories of 160 relatives. There was a high prevalence of anxiety disorders among first-degree relatives of subjects with panic attacks. There was no significant difference in the prevalence of mood disorders and substance abuse between first-degree relatives of subjects with (N = 45) and without (N = 115) panic attacks. The results suggest that individuals with a family history of anxiety disorders may be vulnerable to lactate-induced panic attacks.

Adult↗

Evidence for central entrainment of the medullary respiratory pattern by the locomotor pattern in the rabbit.

1) Although periodic passive hindlimb movements can reproduce the enhancement of breathing frequency seen at the onset of muscular exercise, we have shown previously that they were unable to induce the 1:1 coupling which is observed between locomotion and respiration during galloping in quadrupeds. The purpose of this study was to investigate the existence of a central coupling in two experimental situations: first, decorticate - DOPA, and secondly, decerebrate rabbit preparations. 2) After DOPA administration in curarized, vagotomized, decorticate animals, an absolute coordination could be observed between the locomotor bursts (which developed in hindlimb muscle nerves) and phrenic activity. With the temporal evolution of the pharmacological activation, the coupling mode varied from 1:1 to 1:2 during the same experiment with a loss of coordination between these two forms. When the coordination between both motor activities was not produced in such conditions, it could be induced for some imposed frequencies of periodic passive motions applied to the contralateral hindlimb. 3) When the DOPA effects were completely over, a rostro-pontine decerebration allowed locomotor activity to be released and a tight 1:1 coupling could be obtained again between the two motor patterns in this new experimental situation. 4) An analysis of the data revealed that the various forms of coordination obtained in the different experimental situations are due to a central resetting of the respiratory and of the locomotor patterns. The capability of the hindlimb proprioceptive inputs to coordinate locomotor and respiratory patterns in the decorticate-DOPA preparation appeared simply linked to their ability to entrain the activity of the lumbar locomotion generator. It is suggested that these central reciprocal interactions, which have the properties of an entrainment process, are the result of interactions between the lumbar locomotion generator and the medullary respiratory one.

Action Potentials↗

Creatinine kinase concentrations and electrocardiographic changes in extracorporeal shock-wave lithotripsy.

A total of 114 consecutive patients undergoing extracorporeal shock-wave lithotripsy had serial creatinine kinase (CK) with isoenzymes and serial electrocardiograms (ECG). There were significant changes in both heart rate and CK post-lithotripsy. However, this did not appear to be due to elevation of the myocardial component of CK. While there were some random ECG changes pre- and post-lithotripsy, none appeared to be directly related to the procedure.

Creatine Kinase↗

Biological effects of shock waves: kidney haemorrhage by shock waves in dogs--administration rate dependence.

The effect of shock waves on normal canine kidneys was examined in two groups of dogs whose right kidneys were exposed to 3000 shock waves generated with 20 kV and 40 nF in a Dornier HM II lithotripter. The groups differed only in the rate of shock wave administration which was 100 and 1 per second, respectively. Autopsy was performed 24 to 30 h later. Macroscopically and histologically, significantly more haemorrhages occurred in the kidney parenchyma if shock waves were administered at a rate of 100 waves per second. Haemorrhages were diffuse, the outer medulla was most heavily affected. The results show that kidney damage is dependent on the rate of shock wave administration. They argue against a direct shock wave effect and favor cavitation as the mechanism of shock wave damage although thermal effects cannot be excluded.

Animals↗

Artificial dermis for major burns. A multi-center randomized clinical trial.

This communication presents an 11-center prospective randomized trial using the artificial dermis invented by Burke and Yannas. Patients with life-threatening burns who underwent primary excision and grafting within 7 days of injury had comparable sites randomized to receive either the artificial dermis (study site) or the investigator's usual skin grafting material (control site). Control materials were autograft, allograft, xenograft, or a synthetic dressing. Epidermal grafts were applied to the study site during a second operation, and surviving patients were followed for 1 year after grafting. One hundred thirty-nine sites on 106 patients were studied. Mean burn size was 46.5 +/- 15% mean total body surface (TBSA). Overall mortality was 13%, and mean hospital stay was 68 +/- 45 days. Median artificial dermis take was 80% compared with 95% for all comparative sites, but the take was equivalent to that of all nonautograft control materials. Results with the artificial dermis improved slightly as the investigators became more familiar with the material. Donor site thickness for the study site averaged .006'' +/- .002'' compared to .013'' +/- .018'' for control (p less than .0001) and the epidermal donor site healed an average of 4 days sooner (10 +/- 6 vs. 14 +/- 8 days) (p less than .0001). As the wounds matured during the first year, both patients and surgeons felt that both sites became more comparable in appearance and function. At the completion of the study, there was less hypertrophic scarring of the artificial dermis, and more patients preferred the artificial dermis to the control graft. Artificial dermis with an epidermal graft provides a permanent cover that is at least as satisfactory as currently available skin grafting techniques, and uses donor grafts that are thinner and donor sites that heal faster.

Adolescent↗

The sensitized patient. A single center study.

1. In a 20-year period from 1966 to 1986, 650 renal transplants have been performed at the Toronto Western Hospital (University of Toronto). The 10-year actuarial patient survival is 62% and the actuarial graft survival is 35%. 2. A multivariant analysis using the Cox proportional hazard model indicated recipient age, donor source, graft number and time period were factors which independently influenced patient survival and that age and time period were variables which independently effected graft outcome. 3. Sensitization alone, using either peak or current PRA, did not significantly influence graft survival. Sensitization interacting with gender did affect graft survival, which was significantly lower in female patients with a high current PRA. Sensitization interacting with age produced different effects in the younger and older patients. The highly sensitized older patient has a better survival than the highly sensitized younger patient. However, for less sensitized patients the reverse was found; younger patients had a better survival than older patients. Also increasing levels of sensitization correlated with decreased survival in younger patients. 4. Predictive models based on the survivorship analysis of Kalbfleisch and Prentice were constructed to illustrate the impact of these variables on outcome.

Actuarial Analysis↗